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Updated: Mar 20, 2026
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Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
Published on: May 25, 2020
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Topiramate associated non-glaucomatous visual field defects.
Sameen Haque1, Mohamed Shaffi2, Kong C Tang3
1Neurology Department, Canberra Hospital, Yamba Dr, Garran, ACT 2605, Australia.
Summary
Topiramate, used for migraine, can cause visual field defects. This case shows improvement after discontinuing the medication, even without angle closure glaucoma.
Area of Science:
- Ophthalmology
- Neurology
Background:
- Topiramate is a medication commonly prescribed for migraine management.
- Visual field defects are a known potential side effect of topiramate.
- These defects are often associated with angle closure glaucoma and ciliochoroidal effusion syndrome.
Observation:
- A 34-year-old woman developed bilateral incongruous inferior visual field defects after starting topiramate for migraines.
- Standard investigations ruled out angle closure glaucoma as the cause.
- The visual field defects showed gradual improvement over several months following topiramate cessation.
Findings:
- The patient's visual field deficits resolved significantly after discontinuing topiramate.
- Unlike typical cases, angle closure glaucoma was not identified.
- Minor persistent visual field changes were noted on the left, possibly influenced by pre-existing myopia and keratoconus.
Implications:
- This case highlights that topiramate-induced visual field defects can occur without angle closure glaucoma.
- Ophthalmologists should consider topiramate as a potential cause of visual field changes, even in the absence of elevated intraocular pressure.
- Establishing a baseline visual field assessment before initiating topiramate therapy is recommended to monitor for treatment-related changes.
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